经皮肾造瘘术治疗上尿路疾病的临床观察

Clinical application of percutaneous nephrostomy for treatment of upper urinary diseases

目的探讨经皮肾造瘘术(PCN)治疗上尿路疾病的可行性。方法回顾性分析应用PCN治疗260例(291侧)上尿路疾病。上尿路结石230例(259侧),肾积脓13例(13侧),肾盂输尿管交接部(UPJ)狭窄10例(10侧)、肾盏憩室3例(3侧),恶性肿瘤致上尿路梗阻、肾功能不全4例(6侧)。结果 260例(291侧)一次手术成功率99.3%(289/291);上尿路结石患者中结石取净率90.7%(235/259),肾积脓治疗成功率94.6%(11/13),UPJ狭窄治疗成功率70%(7/10),3例肾盏憩室均治疗成功,4例恶性肿瘤致上尿路梗阻、肾功能不全行PCN后肾功能恢复正常。结论 PCN具有创伤小、安全、疗效可靠、并发症少等优点,在上尿路疾病的治疗中具有较高的临床应用价值。

Objective To investigate the ieaslblhty ot percutaneous nephrostomy（PCN） tor treaung upper urinary diseases. Methods The data of 260 cases（291 sides） with upper urinary diseases who underwent PCN were retrospectively reviewed,including 230 cases of renal calculi and proximal ureteral calculi, 13 cases of pyonephrosis, 10 cases of ureteropelvic junction（UPJ） strictures,3 cases caliceal diverticulum,and 4 cases of urinary obstruction and renal insufficiency caused by tumor. Results Of all the 260 cases （291 sides） ,PCN one-time success rate was 99.3 % （289/291） ,and the stone clearance rate of the patients with upper urinary tract stones was 90.7%（235/259）. The cure rate of pyonephrosis and UPJ strictures were 94.6%（11/13） and 70%（7/10） respectively,all the 3 cases of calyceal diverticulum were cured,and the renal function of 4 cases of urinary obstruction and renal insufficiency caused by tumor returned to normal gradually after the treatment by PCN. Conclusion Percutaneous nephrostomy （PCN） has advantages of fewer traumas, safe,efficient and less complication,thus having important clinical value for the treatment of upper urinary diseases.